Pedtricia

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Pedtricia

  1. 1. Paediatrica Indonesiana Indonesian Journal of Pediatrics and Perinatal Medicine Advisory Board Bambang Madiyono, Husein Alatas, I. G. N. Gde Ranuh, Iskandar Wahidiyat, Mulyono Trastotenojo, Sofyan Ismael Business Manager Sofyan Ismael Editor-in-Chief Sudigdo Sastroasmoro Managing Editor Partini P Trihono . Editors Rulina Suradi Aryono Hendarto Maria Abdulsalam Rinawati Rohsiswatmo Budining Wirastari Erwin Soenggoro Asti Praborini Muljadi M. Djer Associate Editors Nia Kurniati Nikmah Salamia Idris Bernie Endyarni Amanda Soebadi Contributing Editors Herlina Dimiati (Aceh) Endy Paryanto (Yogyakarta) Muhammad Ali (Medan) Aryanto Harsono (Surabaya) Finny Fitri Yani (Padang) Siti Lintang Kawuryan (Malang) Ria Nova (Palembang) Syarifuddin Rauf (Makassar) Darmawan Budi Setyanto (Jakarta) Endang Dewi Lestari (Solo) Heda Melinda (Bandung) Hesti Lestari (Manado) Mexitalia Setiawati (Semarang) Ida Bagus Subanada (Bali) International Editorial Board Robert Ouvrier (Sydney) B. J. Brabin (Liverpool) Victor Y. H. Yu (Melbourne) Perla D. Santos Ocampo (Manila) Hans A Buller (Rotterdam) Mohd Sham Kasim (Kuala Lumpur) J. L. Wilkinson (Melbourne) Habil B. Lombay (Hungary) Prasong Tuchinda (Bangkok) Akihiro Morikawa (Tokyo) Address: Department of Child Health, Medical School, University of Indonesia Jalan Salemba 6, Jakarta 10430, Indonesia Tel. 62-21-314 7342, Fax. 390 7743
  2. 2. Hanya untuk kalangan sendiri, tidak diperjual-belikanIn-house style Paediatrica Indonesiana
  3. 3. PengantarBuku ini dibuat untuk panduan bagi para penulis, contributing editors, sertaeditor Paediatrica Indonesiana. Seperti kita ketahui, setiap jurnal ilmiahmempunyai in-house style (gaya selingkung) yang harus diterapkan secarakaku dan taat-asas. Pengalaman menunjukkan bahwa sebagian besarpenulis tidak sepenuhnya mengikuti tata cara penulisan yang termuat dalamInstructions to Authors maupun yang dapat dilihat dalam artikel yang telahditerbitkan. Seringkali ketidaksesuaian tersebut hanya bersifat “kecil” danmungkin diangap tidak mendasar. Namun tetap saja hal tersebut memerlukanpenyesuaian atau koreksi yang harus dilakukan leh editor / staf editorsehingga memerlukan waktu yang tidak sedikit. Pembiaran terhadap variasitersebut akan mengurangi kualitas jurnal ini.Dengan terbitnya buku ini diharapkan para contributing editors dapatmemastikan bahwa artikel yang akan dikirim ke Paediatrica Indonesianasudah dibuat sesuai dengan in-house style jurnal kita. Hal ini akanmemperlancar proses editing dan penerbitan artikel, yang akan menunjangproses internasionalisasi Paediatrica Indonesiana.Buku ini dibuat untuk pemakaian intern dan tidak diperjualbelikan.Mengingat sebagian besar penulis Paediatrica Indonesiana adalah dariinstitusi pendidikan, maka buku ini dibagikan secara cuma-cuma kepadasemua Pusat Pendidikan Dokter Spesialis Anak. Para contributing editors, yangtelah mengkuti lokakarya sosialisasi buku ini, diharapkan dapat menjadi narasumber bagi para calon penulis Paediatrica Indonesiana di institusi masing-masing. Buku ini juga dapat diakses dan diunduh oleh peminat melalui websitewww.paediatricaindonesiana.org.Jakarta, September 2010 Editor-in-ChiefPaediatrica Indonesiana
  4. 4. In-house style1. Title• Judul makalah merupakan hal yang paling awal dan paling banyak dibaca orang. Dari judul pembaca akan menentukan apakah akan membaca artikel lebih lanjut atau tidak. Dengan demikian judul harus dibuat dengan cermat; ia harus ringkas, informatif, menarik.• Judul bukan merupakan kalimat lengkap, namun lebih merupakan label.• Judul naskah PI menggunakan sentence case (huruf besar hanya untuk huruf pertama dari kata pertama, atau nama diri).• Judul tidak terlalu panjang atau pendek. Intinya: judul terbaik adalah judul yang paling pendek yang menggambarkan isi utama penelitian. Meskipun sulit ditentukan jumlah maksimum kata, namun usahakan tidak lebih dari 24 kata. Untuk membuat judul yang ringkas, kata-kata berikut dihilangkan: o A study of o Investigation of ...... o Observation on o The ..., A...., An......• Judul tidak menggunakan singkatan atau akronim kecuali yang baku.• Tempat dan waktu penelitian tidak perlu disertakan dalam Judul kecuali bila penelitian khas untuk waktu dan tempat tersebut.• Judul tidak menggunakan kalimat tanya.• Dianjurkan untuk tidak menyebutkan hasil utama penelitian sebagai judul.• Penyertaan desain penelitian, bila sesuai, dapat dilakukan dalam judul.• Hindarkan pernyataan yang berlebihan, seperti: A prospective randomized double blind placebo controlled clinical trial. (Tidak ada uji klinis yang tidak prospektif, tidak ada plasebo yang tidak double blind); jadi cukup: A randomized double blind clinical trial.)Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 1
  5. 5. In-house style Judul yang salah / tidak dianjurkan Judul terlalu panjang: Control study of comparative efficacy of isoniazid, streptomycin-isoniazid, and streptomycin-para-amninosalycilic acid in pulmonary tuberculosis therapy. III. Repart on twenty-eight-week observations on 649 patients with streptomycin-susceptible infection Am Rev Tuberc. 1953;67:539-543. [Komentar: terlalu panjang dan rinci, mirip sinopsis]. Judul terlalu pendek: Antibiotics in neonatal sepsis. [Komentar: terlalu pendek dan terlalu umum, lebih merupakan judul tinjauan pustaka ketimbang judul penelitian]. Judul yang secara tidak perlu mencantumkan nama tempat dan waktu penelitian Effect of the use of oral iron chelating agent in patients with beta-thalassemia at the Department of Child Health, Cipto Mangunkusumo Hospital, 2008. [Komentar: Efek obat khelasi tersebut tidak hanya berlaku di RSCM dan pada tahun 2008 saja, jadi tempat dan waktu tidak perlu dicantumkan]. Judul berupa “kalimat tanya” Can antibiotic decrease length of hospital stay in children with measles pneumonia? [Komentar: Kalimat tanya dapat digunakan untuk rubrik editorial atau opini, bukan laporan hasil penelitian]. Judul berupa hasil utama penelitian Routine antibiotic use for acute otitis media is useless. [Komentar: Judul berupa hasil utama penelitian dibenarkan di beberapa jurnal; untuk PI pada umumnya tidak].2 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  6. 6. In-house style Judul yang benar / dianjurkan Judul yang secara benar mencantumkan nama tempat dan waktu penelitian • Five-year experience of bone marrow transplantation for patients with acute lymphoblastic leukemia, Cipto Mangunkusumo Hospital, Jakarta, 2002-2006. [Komentar: pengalaman tersebut khas di RSCM antara tahun 2002-2006, tidak berlaku di tempat atau kurun waktu lain.] Contoh judul laporan penelitian yang baik • Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Arch Pediatr Adolesc Med. 2005;159:502-3. • Probiotics in prevention of antibiotic associated diarrhoea: systematic review and meta­ nalysis. bmj.com 2002;324:1361 a • Effect of moderate diet-induced weight loss and weight regain on cardiovascular structure and function. J Am Coll Cardiol, 2009; 54:2376-81. • Chagas disease as a cause of symptomatic chronic myocardopathy in Mexican children. Pediatr Infect Dis J. 2009;28:1011-3. • Amethocaine versus EMLA for successful intravenous cannulation in a children’s emergency department: a randomised controlled study. Emerg Med J 2009;26:487-91. • Comparison of results and complications of surgical and Amplatzer device closure of perimembranous ventricular septal defects. Cardiology 2001;120:28-31. • Bicycle helmet use among schoolchildren—the influence of parental involvement and children’s attitudes. Inj Prev. 2001;7:218-222 Catatan. Untuk penulisan judul, Paediatrica Indonesiana tidak menggunakan title case (huruf awal setiap kata ditulis dengan kapital), melainkan menggunakan sentence case (huruf kapital hanya digunakan pada awal judul, sedangkan selebihnya digunakan huruf kecil (lowercase), kecuali untuk nama diri (proper names). Penulisan dengan “title case” – tidak digunakan dalam Paediatrica Indonesiana • Kangaroo Mother Versus Traditional Care for Newborn Infants Less than or Equal to 2000 Grams: A Randomised Controlled Trial. Penulisan dengan “sentence case” – digunakan oleh Paediatrica Indonesiana • Kangaroo mother versus traditional care for newborn infants less than or equal to 2000 grams: a randomised controlled trial.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 3
  7. 7. In-house style2. Authors & CorrespondenceNama pengarang dituliskan tanpa gelar / titel apa pun.• Penulisan nama pengarang dimulai dengan nama pertama (lengkap), diikuti dengan nama tengah (jika ada, boleh lengkap atau inisial) dan nama keluarga (lengkap).• Bila tidak ada nama keluarga, maka nama akhir yang dianggap sebagai nama keluarga.• Jika pengarang berasal lebih dari satu institusi, berikan nomor (superskrip) di belakang nama tiap pengarang.• Tuliskan nama institusi (Departemen, Fakultas, Universitas / Rumah Sakit) dengan lengkap dan jelas. Untuk keseragaman, nama bagian / departemen disebut Department, untuk nama sub-bagian atau divisi disebut sebagai Division.• Alamat surat menyurat ditulis seperti berikut: ‘‘Reprint requests to:……’ dengan alamat kantor, telepon kantor, nomor faksimile, dan alamat e-mail.4 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  8. 8. In-house style Contoh penulisan nama pengarang dari institusi yang sama: • Syukur Pribadi, Marulam T. Panggabean, Soenarto, Sri Endah Sulistyowati, I G. N. Made Sanjaya o From the Department of Child Health, Medical School, Mulawarman University, Jakarta, Indonesia. o Reprint request to: Syukur Pribadi, MD, Department of Child Health, Medical School, Mulawarman University, Jalan Mulawarman no. 34-38, Jakarta 10430, Indonesia. Tel +62-21- 89898989, Fax +62-21-89898988, email: s_pribadi@indonet. com. Contoh penulisan nama pengarang dari institusi yang berbeda: • Miranda Francisca Situmeang1, Nanda Syavitri2, Rukmana Sulanjana3, Wibisono4 o From the Departments of Child Health1 and Surgery2, Medical School, and School of Public Health3, Mulawarman University, Jakarta, Indonesia, and Helix Laboratories4, Jakarta, Indonesia. o Reprint request to: Miranda F. Situmeang, Department of Child Health, Medical School, Mulawarman University, Jalan Mulawarman no. 34-38, Jakarta 10430, Indonesia. Tel +62-21- 89898989, Fax +62-21-89898988, email: situmeang0409@ indonet.comHanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 5
  9. 9. In-house style3. Abstract & keywords• Abstrak merupakan bagian kedua yang paling banyak dibaca setelah judul karangan. Dalam abstrak harus tergambar keseluruhan isi karangan, dari pendahuluan sampai simpulan.• Paediatrica Indonesiana menggunakan abstrak terstruktur (structured abstract) dengan subjudul, mulai dengan Objective, Methods, Results, Conclusions.• Abstrak tidak lebih dari 250 kata (gunakan word count – pada program komputer), dan tidak memuat singkatan atau akronim yang tidak standar.• Abstrak harus informatif; termasuk jangan hanya memaparkan nilai P untuk menunjukkan perbedaan yang bermakna, namun harus disertakan berapa beda atau korelasi yang ada. Contoh Results dalam abstrak berikut tidak dapat dibenarkan: Results. There were 220 patients completed the sudy, 112 in the treament group and 108 in placebo group. There was a significant difference between the treatment group and placebo group terms of number of visits (P = 0.03), proportion of cured (P = 0.034), but there was no significant difference in total cholesterol level (P = 0.076). [Komentar: harus disebutkan berapa beda klinis (lebih baik dengan interval kepercayaannya) dan tidak boleh hanya nilai P saja.] Seharusnya dituliskan sebagai berikut: Results. There were 220 patients completed the sudy, 112 in the treament group and 108 in placebo group. There was a significant difference between the treatment group and placebo group terms of number of visits (mean difference 4.6 mg/dL, 95% confidence interval 2.1 to 7.1 mg/dL, P = 0.03), proportion of cured (risk reduction 16%, 95% confidence interval 7 to 25%, P = 0.027), but there was no significant difference in total cholesterol levels (mean difference 6 mg/dL, 95% confidence interval -2 to 14 mg/dL, P = 0.096).• Kata kunci: Terdiri atas 3-8 kata atau terminologi yang berdasarkan MeSH (Medical Subject Heading).6 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  10. 10. In-house style Contoh - Abstract Increased pulmonary arterial pressure in children with nephrotic syndrome Arch Dis Child. 2004;89:866-870 Aims: To evaluate pulmonary arterial pressure in children with nephrotic syndrome (NS). Methods: Doppler echocardiography was performed in 40 children with NS (aged 1.5– 13 years) at NS onset (n = 28) or relapse (n = 12), and 40 normal controls. Pulmonary pressure was estimated by: (1) measuring the systolic transtricuspid gradient from tricuspid regurgitation; and (2) measuring the time to peak velocity of pulmonary flow. Results: Thirty five of the 40 patients with NS had measurable tricuspid regurgitation with a pulmonary systolic pressure ranging from 21 to 48 mm Hg. Pulmonary systolic pressure was >40 mm Hg in seven patients. The pulmonary time to peak velocity was shortened and the ratio of time to peak velocity and right ventricular ejection time decreased compared with controls. The patients with increased pulmonary pressure had a longer time since onset of NS. One patient developed thrombus in the inferior vena cava during hospitalisation. Conclusion: Pulmonary arterial pressure was increased in children with NS. Further work is needed to evaluate the aetiology and clinical implications of this abnormality. Keywords: nephrotic syndrome; hypertension; pulmonary; Doppler echocardiographyHanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 7
  11. 11. In-house style Contoh - Abstract Amethocaine versus EMLA for successful intravenous cannulation in a children’s emergency department: a randomised controlled study Emerg Med J. 2009;26:487-491 Background: Topical anaesthetics reduce the pain of venous cannulation. The emergency department at the Starship Children’s Hospital in Auckland uses EMLA (an eutectic mixture of 25 mg/g lidocaine and 25 mg/g prilocaine) for topical anaesthesia. Amethocaine has recently been shown to be a more effective topical anaesthetic. It is suggested that, because amethocaine does not vasoconstrict veins, it may increase the success of cannulation. Aim: The primary aim was to determine if amethocaine improves the success of cannulation compared with EMLA. The secondary aim was to determine if amethocaine is a more effective topical anaesthetic in a children’s emergency department. Methods: A parallel, randomised, double-blind controlled study was performed in children aged 3 months to 15 years who were offered topical anaesthesia for venous cannulation. Caregivers gave verbal consent at triage, followed by written consent. Children were randomised into amethocaine or EMLA groups. Those who went on to have an intravenous cannula were analysed on an intention-to-treat basis. The primary outcome was a successful first attempt at cannulation. A convenience cohort was also observed for distress using a visual analogue scale and the Faces, Legs, Activity, Cry and Consolability Score. Results: From November 2006 to June 2007, 2837 children were enrolled and 809 were known to have had intravenous cannulation. 679 complete data and consent forms were returned. There was no significant difference between the first attempt success rates (75.8% amethocaine vs 73.9% EMLA) or between pain scores for the 65 observed cannulations. Conclusion: Amethocaine is not more successful than EMLA for first attempt intravenous cannulation in a children’s emergency department. 8 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  12. 12. In-house style Contoh - Abstract Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar BMJ 2001;323:1389-1393 Objective: To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design: Double blind, placebo controlled randomised factorial trial of iron & anthelmintic treatment. Main outcome measures: Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. Results: Before intervention, anaemia was prevalent, and geohelminth infections were prevalent and light Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale, and also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P=0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations <90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of A. lumbricoides and T. trichiura infections, but not by hookworms. Mebendazole increased development scores by 0.4 (-0.3 to 1.1) points on motor scale and 0.3 (-0.3 to 0.9) points on language scale. Conclusions: Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration <90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 9
  13. 13. In-house style Contoh - Abstract Survey of hepatitis B surface variant infection in children 15 years after a nationwide vaccination programme in Taiwan Gut 2004;53:1499-1503 Background: It is not known whether hepatitis B virus (HBV) with mutations in the a determinant (amino acids (aa) 121–149) of the hepatitis B surface antigen (HBsAg) affect vaccination efficacy. Aim: To investigate the prevalence and clinical significance of these mutants in children, 15 years after universal vaccination in Taiwan. Methods: Nucleotide sequences encoding the a determinant region (aa 110–160) of HBsAg were analysed in all HBV-DNA positive sera from 1357 children and 219 adolescents serosurveyed in 1999. We then compared the prevalence and changes in the mutants in these children with our previous surveys in the same area conducted in 1984 (just before vaccination), 1989, and 1994. Results: The prevalence of a determinant mutants in HBV-DNA positive children was 7.8% (8/103) in 1984, which significantly increased to 19.6% (10/51) in 1989, peaked at 28.1% (9/32) in 1994, and remained at 23.1% ((3/13) (T131I, G145R, G145R)) in 1999; it was higher in those fully vaccinated compared with those not vaccinated (15/46 v 15/153; p<0.001). However, the number of mutant infected children in each survey was stable in the first 5–10 year period but decreased 10–15 years post vaccination. Increased amino acid variation in the a determinant region occurred in carrier children in the post vaccination survey. Mutated residues tended to occur more frequently in the region with greater local hydrophilicity (residues 140–149) in those vaccinated than in unvaccinated children with variant infection (12/15 v 6/15; p = 0.062). More HBsAg positive a determinant mutants emerged in children fully vaccinated with plasma derived vaccine than those given recombinant vaccine (10/2399 (0.46%) v 0/503; p = 0.122). Conclusion: We found that a determinant variants have an advantage in infecting immunised children but do not threaten current HBV vaccination strategies in Taiwan.10 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  14. 14. In-house style Contoh - Abstract Bicycle helmet use among schoolchildren—the influence of parental involvement and children’s attitudes Inj Prev. 2001;7:218-222 Objective—To study attitudes towards and use of bicycle helmets among schoolchildren; to determine whether these attitudes are associated with the involvement of parents and school in bike safety. Settings—Nine intermediate level schools and five upper level schools in two Swedish municipalities. Method—A survey with 1485 participants aimed at pupils aged 12–15 years conducted during late spring 1997. Associations between parent and school involvement and children’s attitudes and helmet use were studied using LisRel analyses. Results—At some point during their school years, a majority of the children stopped wearing bicycle helmets. Of 12–13 year olds, 80% said that they had used helmets when they were younger but at the time of the study, only 3% aged 14–15 years used helmets. Use decreased significantly during school years (p<0.001). The majority stated they quit using helmets because they were ugly, silly, uncomfortable, or inconvenient. There was a strong association between parental involvement, children’s attitudes, and helmet use. However, parent involvement decreased as the children grew older. Conclusions—To increase the voluntary use of bicycle helmets among schoolchildren their attitudes must be influenced. An intervention aimed at both parents and children may be required.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 11
  15. 15. In-house style Contoh - Abstract Growth velocity in elementary school children with iron deficiency anemia after iron therapy Paediatr Indones. 2009; Background Iron supplementation could decrease the incidence of stunting in children with iron deficiency anemia . Objective To study the effect of iron therapy on growth velocity in children with iron deficiency anemia. Method A randomized clinical trial study was conducted at Labuhan Batu on November 2006 to May 2007. Iron deficiency anemia was diagnosed if anemia was present with mean corpuscular hemoglobin concentration <31%, red cell distribution width index >220, and Mentzer index >13. Elementary school children (6-12 years old) with iron deficiency anemia were randomly assigned to a daily therapy of 6 mg iron/kg/day or placebo for three months. The body height was evaluated before intervention and six months after intervention. Results There were 125 children, among 300 children recruited, who suffered from iron deficiency anemia. After one month of iron therapy, the means of hemoglobin concentration were 12.4 g/dl in iron group and 11.7 g/dl in placebo group. There was a significant increment of height in iron group (129.9 (SD 7.58) cm vs. 132.2 (SD 7.23) cm) and in placebo (130.8 (SD 8.78) cm vs. 128.7 (SD 8.79) cm) group, but no significant difference in the mean of growth velocity between placebo and iron groups (2.1 (SD 0.01) cm vs. 2.0 (SD 0.9) cm. Conclusion There is significant increase in height, but no significant difference in growth velocity between the two groups.12 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  16. 16. In-house style4. Introduction• Pendahuluan suatu laporan penelitian intinya menguraikan dengan ringkas pembenaran (justifikasi) mengapa penelitian perlu dilakukan.• Berbeda dengan Pendahuluan untuk usulan penelitian yang seringkali sepanjang 3-6 halaman atau lebih, Pendahuluan untuk laporan penelitian di jurnal harus dibuat ringkas. Biasanya informasi yang diperlukan dalam Pendahuluan cukup diuraikan dalam 2 atau 3 paragraf, dan secara keseluruhan tidak lebih dari 1 halaman.• Paragraf pertama berisi latar belakang penelitian (justifikasi mengapa penelitian perlu dilakukan): apa yang sudah diketahui, apa yang perlu ditambahkan.• Paragraf kedua berisi hipotesis atau tujuan penelitian.• Pendahuluan harus didukung oleh pustaka yang relevan dan kuat, namun tidak perlu diuraikan secara rinci. Misalnya bila ingin ditekankan bahwa masalah yang diteliti masih kontroversial, lukiskan kontroversi tersebut dengan rujukan yang kuat namun tidak perlu diuraikan secara rinci. o Manfaat pemberian antibiotik pada bayi dan anak dengan otitis media akut masih kontroversial; sebagian ahli menyarankan pemberian antibiotik sedini mungkin setelah diagnosis ditegakkan,3-7 sebagian lainnya menganjurkan pemberian antibiotik setelah periode menunggu selama beberapa hari terlebih dahulu.8-12 Jadi tidak perlu dirinci apa yang dilaporkan oleh rujukan nomor 3, 4, 5 dan seterusnya sampai nomor 12. Bila rincian tersebut diangap penting, hal tersebut dapat dikemukakan dalam Pembahasan (Discussion).Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 13
  17. 17. In-house style Contoh - Introduction Comparative efficacy of inactivated and live attenuated influenza vaccines [N Eng J Med. 2009;361:1260-67] INTRODUCTION Two different types of vaccine for the prevention of seasonal influenza are currently licensed, one containing inactivated viruses and the other containing live attenuated viruses. Both vaccines are trivalent, with the three components updated annually as needed on the basis of national and international recommendations.1 The efficacy of both vaccines can be affected by a number of factors, including the age and health of the vaccine recipients, and by the extent of antigenic similarity between the strains included in the vaccines and those that actually circulate months later.2-6 Thus, there can be differences in efficacy from year to year. There are also issues related to the fact that although two distinct type B lineages have recently been in circulation each year, only one can be included in the licensed vaccines.7 Similar issues may be encountered if the novel influenza A (H1N1) virus of swine origin continues to circulate along with viruses of human origin.8 Beginning in the 2004–2005 influenza season, we conducted a series of annual studies to estimate the absolute and relative efficacies of licensed inactivated and live attenuated vaccines in healthy adults younger than 50 years of age.9,10 We report here estimates of the efficacies of the two vaccines in the 2007–2008 season, using end points determined by viral culture and polymerase-chain-reaction (PCR) assay. Influenza-related morbidity was high in 2007–2008, a year in which type A (H3N2) viruses predominated; these viruses were characterized by a slight antigenic drift from the type A (H3N2) viral strain included in the vaccine.14 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  18. 18. In-house style Contoh - Introduction Effect of introduction of the pneumococcal conjugate vaccine on drug- resistant Streptococcus pneumoniae. N Engl J Med 2006;354:1455-63 INTRODUCTION Antibiotic-resistant pneumococci complicate treatment decisions, cause treatment failures, and increase the costs of medical care. Worldwide, most antibiotic-resistant infections are caused by five of the seven serotypes in the 7-valent pneumococcal conjugate vaccine (6B, 9V, 14, 19F, and 23F).1 In 1998, 24 percent of invasive pneumococcal isolates in the United States were nonsusceptible to penicillin, and these five serotypes comprised 78 percent of such strains.2 Modeling predicted that in the absence of a pneumococcal conjugate vaccine, the proportion of pneumococcal strains that were nonsusceptible to both penicillin and erythromycin could reach 41 percent by 2004.3 Because of the association between serotype and resistance, the conjugate vaccine would be expected to reduce the incidence of disease caused by resistant strains, even though the vaccine is designed to induce antibodies against certain capsular types. A pneumococcal conjugate vaccine was licensed for use in young children in the United States in 2000. The vaccine is recommended for all children under two years of age and for children two to four years of age who have certain chronic illnesses or other high-risk conditions.4 Data from 20015 and from a single site in 20026 indicated that there had been a large decrease in invasive disease, including infections caused by resistant strains. Whether vaccine use would induce the emergence of serotypes that were typically not resistant as clinically significant causes of resistant infections was unknown. In addition, the possibility that use of a vaccine that targets only 7 of 90 pneumococcal serotypes would lead to an increase in disease by nonvaccine types (so-called replacement disease) was a concern. We used population-based data from Active Bacterial Core surveillance, part of the Emerging Infections Program of the Centers for Disease Control and Prevention (CDC), to evaluate further the effect of the conjugate pneumococcal vaccine on invasive disease caused by antibiotic-resistant strains in the United States.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 15
  19. 19. In-house style Contoh - Introduction Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia - a randomized clinical trial Arch Intern Med. 2007;167:346-53. Garlic (Allium sativum) has been used medicinally since antiquity. Garlic supplements, many of which seek to package the benefits of raw garlic in more palatable forms,1-5 are promoted as cholesterol-lowering agents and are among the top-selling herbal supplements.6-7 Crushing garlic triggers the formation of allicin through action of alliinase enzymes on the stable precursor alliin, and allicin inhibits cholesterol synthesis in vitro.8-9 Despite promising in vitro studies and a strong plausibility of effect demonstrated in more than 110 animal studies,10 the clinical trial evidence supporting a hypocholesterolemic effect of various forms of garlic is highly inconsistent.11- 19 A strong criticism of these trials has been that the bioavailability of the important sulfur- containing constituents differs significantly between raw garlic and the specific garlic supplement formulations.19-22 The objective of the current study was to compare the effect of raw garlic and of 2 garlic supplements with distinctly different formulations on the plasma lipid concentrations of adults with moderate hypercholesterolemia for 6 months. Postcataract surgery outcome in a series of infants and children with Down syndrome Br J Ophthalmol. 2008;92:1112–6. Down syndrome is the most common genetic cause of developmental disability in Ireland with a prevalence of one in 546 live births,1 the highest in Europe. An Irish cross-sectional study of 394 children and adolescents with Down syndrome found that 50% of the children had ophthalmic pathology, high myopia most commonly (24.9%) with 4.6% having cataracts.3 There is an increased incidence of both acquired (11–60%2,4–6) and congenital cataracts (2–6%6,7,11, 12). This retrospective study reports the visual and refractive outcome and complications in children with Down syndrome undergoing cataract extraction.16 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  20. 20. In-house style Contoh - Introduction The usefulness of a new rapid diagnostic test, the First Response® Malaria Combo (pLDH/HRP2) card test, for malaria diagnosis in the forested belt of central India Malaria Journal 2008,7:126 Malaria is a major public health problem in tribal belt of Central India where only two Plasmodium species, i.e. Plasmodium falciparum and Plasmodium vivax are prevalent [1,2]. The ethnic tribes that live in these areas often travel several hours or days to reach the nearest Primary Health Centre (PHC). In such areas laboratory facilities for diagnosis of malaria are often not available and the clinical signs alone can not identify patients with malaria. Diagnosis of malaria made on the basis of clinical symptoms is at best 50% accurate [3]. Further, PHC’s clinics examining blood smears from a large number of clinically suspected patients are often limited by one or two trained microscopists resulting in misleading interpretation and underestimation of malaria parasites. Consequently, a considerable proportion of drugs have been wasted on patients with non malarial disease due to lack of prompt and accurate laboratory diagnosis. Presumptive treatment of malaria encourages the development and spread of drug resistant P. falciparum parasites [4]. Early diagnosis and prompt treatment (EDPT) of malaria with efficient drugs is required for effective malaria control. Several rapid diagnostic test (RDTs) kits for malaria exist for situations in which reliable microscopy may not be available [5,6]. These tests are based on the detection of antigens released from parasitized red blood cells [7]. In the case of P. falciparum, these RDTs are based on detection of the P. falciparum histidine rich protein 2 (HRP2) or of the Plasmodium specific lactate dehydrogenase (pLDH). Species specific pLDH isoforms have been used to develop a test for P. vivax [8]. Recently another rapid test First Response® Combo Malaria Ag (pLDH/HRP2) card test was developed in India for differential diagnosis between P. falciparum and the other plasmodium species. To determine the usefulness of new rapid test in low endemic area where both P. falciparum and P. vivax are prevalent, the diagnostic capacity of First Response® Combo Malaria Ag (pLDH/HRP2) card test (Premier Medical Corporation Ltd., Mumbai, India) was compared with that of expert microscopy, the gold standard. Additionally, the ease of use and accuracy of the test was also assessed.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 17
  21. 21. In-house style Contoh - Introduction Multimicronutrient supplementation for undernourished pregnant women and the birth size of their offspring Arch Pediatr Adolesc Med. 2007;161:58-64. Low birth weight (LBW) (<2500 g) is a major predictor of neonatal and infant mortality.1 Intrauterine growth retardation, rather than prematurity, is the principal cause of LBW in South Asian countries.2 Infants who are small or disproportionate in size at birth also have an increased risk of developing coronary heart disease, type 2 diabetes mellitus, stroke, and hypertension during adult life. It is postulated that these diseases are programmed by inadequate supply of nutrients to the developing fetuses (the Barker hypothesis).3 Thus, measures to increase the size of infants at birth constitute a priority area in developing nations. Prepregnancy and maternal undernutrition are important predictors of reduced birth weight in resource-poor settings.1-2,4 It now appears that several nutrient factors, including both macronutrients and micronutrients, may be deficient in mothers in developing countries.5-6 The habitual diet of women belonging to low-income groups is deficient not only in calories and proteins but also in vitamin C, vitamin E, folate, vitamin B complex, and trace elements such as iron, zinc, magnesium, manganese, and selenium. In a study of 513 pregnancies in Hackney, England, Doyle et al7 reported that mothers who subsequently gave birth to LBW infants had low intake of 43 of 44 nutrients, including copper, zinc, magnesium, vitamin A, vitamin C, vitamin E, and vitamin B complex. Another study of rural Indian women documented a strong relationship between infant birth weight and the mother’s intake of foods rich in micronutrients, suggesting that these may be important limiting factors for fetal growth in undernourished mothers.5 Compared with iron and folic acid supplementation, community-based studies in Nepal8 and Mexico9 have failed to document an increase in birth weight or a decline in the incidence of LBW after antenatal multimicronutrient supplementation. On the other hand, recent trials conducted by Osrin et al10 in Nepal and Kaestel et al11 in Guinea-Bissau demonstrated an increase in the birth size with antenatal multimicronutrient supplementation. Friis et al12 conducted another randomized trial in Zimbabwe and concluded that antenatal multimicronutrient supplementation may be one strategy to increase birth size, although their results failed to achieve a statistically significant difference. However, these trials did not selectively target undernourished pregnant women who are at greater risk for delivering infants with lower birth size. We therefore evaluated the effect of multimicronutrient supplementation in undernourished pregnant women on birth size and early neonatal morbidity.18 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  22. 22. In-house style5. Methods• PI menggunakan subjudul Methods, tanpa menambahkan kata-kata lain seperti Materials and Methods, Subjects and Methods, dll.• Para peneliti muda cenderung untuk menuliskan Methods dengan amat singkat (2 sampai 3 paragraf saja), padahal penulisan Methods harus cukup rinci sehingga orang lain dapat mengulangi penelitian tepat seperti yang dilaporkan. Dalam banyak jurnal Methods ditulis dengan huruf yang lebih kecil, mengingat panjangnya uraian di dalamnya.• Pada umumnya, Metode mengandung beberapa informasi, termasuk: o Desain penelitian o Tempat dan waktu o Populasi dan sampel o Kriteria pemilihan (inklusi dan eksklusi) o Cara pemilihan sampel (sampling method) o Perkiraan besar sampel, tidak harus disertakan formulanya o Randomisasi: teknik randomisasi, apakah dilakukan concealment o Penyamaran (blinding/masking): jenis, teknik o Informasi terinci tentang bagaimana penelitian ini dilakukan, termasuk pengukuran dan intervensi, supaya jika mau mengulang penelitian ini dapat dilakukan sama persis. o Uji kappa untuk kesuaian pengukuran o Tata cara pelaksanaan penelitian o Obat dan alat yang digunakan (nama, jenis, tipe, pabrik) o Follow-up o Outcome primer dan sekunder o Definisi variabel yang penting (secara naratif, tidak dengan penomoran) o Cara pengumpulan dan manajemen data o Analisis dilakukan dengan uji yang sesuai dengan data, batas kemaknaan, disertakan interval kepercayaan o Ethical clearence dan persetujuan setelah penjelasan (informed consent) o Program komputer yang digunakan• Sub-judul dapat digunakan untuk membuat penyajian lebih informatif pada seksi Metode, dan juga Hasil dan Diskusi.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 19
  23. 23. In-house style Contoh - Methods Increased prevalence of renal and urinary tract anomalies in children with Down syndrome [Pediatrics 2009;124: 615-21] METHODS Study Design This was a retrospective cohort study. The occurrence of RUTAs (International Classification of Diseases, Ninth Revision code 753) was determined for children with DS and compared with that for children without DS who were born in New York State (NYS) in 1992–2004. Data Sources Our data were obtained from the NYS Congenital Malformation Registry (NYS-CMR), a statewide birth defect registry that requires reporting of any child with a birth defect diagnosed up to the age of 2 years.9 This is one of the largest, population-based, birth defect registries in the country. It is a repository for case reports of children born in NYS; it permits monitoring of congenital malformations and allows for etiologic studies. The NYS-CMR was established in 1982, and the first full year of data was 1983. Case reporting was performed with written forms until 2006, when electronic reporting with the Internet-based Health Provider Network began. All information reported is kept confidential and is protected by public health law. The NYS-CMR has been used in numerous analyses10–14 and collaborative research projects, including the National Down Syndrome Project and the National Birth Defects Prevention Study.15,16 Statistical Analyses Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each congenital abnormality by using MedCalc 9.2.0.1 (MedCalc Software, Belgium). ORs and CIs were rounded to 1 decimal place. Catatan: Uraian tentang desain yang terlalu kaku hendaknya dihindarkan, seperti: This study was a descriptive and analytic study with cross sectional design …. (Cukup ditulis: This was a cross sectional study ……) This was a prospective randomized placebo controlled trial …… (Cukup diulis: This was a randomized controlled trial…..)20 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  24. 24. In-house style Contoh – Methods Evaluation of universal antenatal screening for group B streptococcus [N Eng J Med 2009; 360:2626-36] METHODS Study Population The Active Bacterial Core surveillance system, a component of the Emerging Infections Program Network, conducts active, population-based surveillance for invasive group B streptococcal disease in selected counties in 10 U.S. states (see the Appendix).14,15 The target study population was infants born alive to surveillance-area residents who delivered at area hospitals at which there were 10 births per year or more during 2003 and 2004; births at these hospitals accounted for nearly all resident births. We used data from a similar evaluation designed to assess births at Active Bacterial Core surveillance sites in 1998 and 1999 in order to compare practices before and after the issuance of the 2002 updated guidelines.9 Colorado joined the Active Bacterial Core surveillance system in 2000, and New Mexico in 2004. Cases of early-onset, invasive group B streptococcal disease, which was defined by the isolation of group B streptococcus from a normally sterile site in a live-born infant less than 7 days of age, were identified by routine population-based surveillance. All cases of group B streptococcal disease that occurred in the birth cohort were included, and each case was assigned a sample weight of 1; because New Mexico joined the Active Bacterial Core surveillance system in 2004, only cases of group B streptococcal disease among infants born in 2004 were captured for that state. For the identification of births in which group B streptococcus was not present, a random sample of 7737 live births stratified according to surveillance area, year of birth, and birth hospital was selected from birth certificates in all 10 Active Bacterial Core surveillance sites. Within each stratum, births were selected by means of proportional allocation on the basis of the number of births per hospital/year. Births in which there was no group B streptococcal disease received an initial sample weight equal to the inverse probability of selection. This initial weight was adjusted to account for nonresponse (i.e., the absence of a chart available for abstraction). This adjustment for nonresponse assumed that within each birth year, hospital, and gestational age category (preterm vs. term), the abstracted charts were representative of all births without group B streptococcal disease.16,17 A Centers for Disease Control (CDC) institutional review board determined that this project protocol was considered to be a program evaluation, and therefore, informed consent was not required. The local institutional review board at each participating site also waived the requirement for consent.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 21
  25. 25. In-house style Data Collection For each selected birth, trained abstractors collected standardized information from labor and delivery records on the mother’s demographic characteristics, prenatal care, obstetrical characteristics, intrapartum antibiotic use, and screening for group B streptococcus. When labor and delivery records for mothers whose newborns had group B streptococcal disease were unavailable for abstraction, routinely collected Active Bacterial Core surveillance case- report data were used to replace missing values, if possible. Information from the birth certificate on race, ethnic group, and term status was used when this information could not be obtained from the medical records. Definitions of Variables Preterm delivery was defined as delivery at less than 37 weeks’ gestation. Intrapartum was defined as the period between the onset of labor or rupture of the membranes and delivery. In the case of cesarean deliveries, intrapartum was defined as the period between admission for labor or delivery and cord clamping. Antibiotics administered for prophylaxis associated with cesarean delivery were not classified as intrapartum when the timing of the administration was unknown. Screening for group B streptococcus before delivery was defined as any documented prenatal test or test at admission that was performed 2 days or more before delivery. The adequacy of prenatal care was determined by the Kessner index, which categorizes prenatal care as adequate, intermediate, or inadequate on the basis of the timing and number of prenatal care visits. For our analysis, we used two categories: inadequate (includes pregnancies with missing data) and adequate (includes intermediate).18 We also used two categories for race: black and nonblack (which included white, Asian or Pacific Islander, American Indian, other, and unknown). A history of group B streptococcus was defined as group B streptococcal bacteriuria in the mother during the current pregnancy or previous delivery of an infant with invasive group B streptococcal disease. Candidates for chemoprophylaxis included women who were positive for group B streptococcus at screening, had a history of group B streptococcus, or had unknown colonization status and a risk factor for group B streptococcus (preterm delivery, an interval between rupture of membranes and delivery of 18 hours or longer, or an intrapartum temperature of 38.0°C [100.4°F]) or higher at labor and delivery.7 Statistical Analysis All analyses were conducted with the use of SUDAAN software, version 9.01 (Research Triangle Institute) to account for the stratified survey design. Data were weighted to account for an unequal probability of selection, and weighted values are reported. Pearson chi-square tests were used to compare distributions of categorical variables, and two-tailed P values of less than 0.05 were considered to indicate statistical significance. Factors associated with not being screened were evaluated with the use of univariate models, and all variables that were significant at a level of less than 0.15 in a univariate analysis were considered in multivariable logistic-regression models. The final multivariable model included main effects with a significance level of less than 0.05. Collinearity and all two-way interactions of main effects were evaluated; interaction P values of less than 0.05 were considered to indicate statistical significance.22 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  26. 26. In-house style Contoh - Methods The usefulness of a new rapid diagnostic test, the First Response® Malaria Combo (pLDH/HRP2) card test, for malaria diagnosis in the forested belt of central India Methods Study area Jabalpur district in central India has a mixed rural, urban and tribal population. This work was performed in Bargi PHC located in forest in 25 km radius, from 21 August – 30 September 2007 during peak monsoon season. The terrain of study area is highly undulating and inaccessible. Villages are remote, thinly populated formed of six to 10 hamlets and located in field and forest. The inhabitants are mainly ethnic Gond tribe (60% – 80%) and agriculture is monsoon-dependant. Inhabitants are poor and live in small, dark, mud plastered huts without electricity. During the rains, perennial streams and its tributaries creates small water pool and remain as potential breeding site for several months in which both the malaria vector, Anopheles culicifacies and Anopheles fluviatilis breed profusely. Medical facilities are non-existent. Sample collection All fever cases in ten villages were screened for malaria independently by microscopy and RDT to evaluate the performance of the test under field conditions. Make-shift field clinics were established in field where persons of all ages visit for checkup, thus permitting performance of the RDT in all persons suspected to have malaria, whatever their history (recent malaria attack or with a history of malaria in the previous 15 days), clinical status (high or low grade fever, severe or mild symptoms) and other factors that may affect the sensitivity and the specificity of the RDT. A questionnaire was filled for each patient with basic clinical and demographic information after taking verbal consent. The RDT kits were opened only after the patient had been selected and interviewed by the medical staff. Blood was obtained by finger prick for the First Response® Combo Malaria Ag (pLDH/HRP2) card test and thick smear before patients received treatment. In all 291 cases were tested by the RDT after taking verbal consent. RDT interpretation The First Response ®Malaria pLDH/HRP2 Combo test contains a membrane strip, which is pre- coated with two monoclonal antibodies as two separate lines across a test strip. One monoclonal antibody (test line 2) is pan-specific to lactate dehydrogenase (pLDH) of the Plasmodium species (P. falciparum, vivax, malariae, ovale) and the other line (test line 1) consists of a monoclonal antibody specific to histidine-rich protein 2 (HRP2) of the P. falciparum species. The conjugate pad is dispensed with monoclonal antibodies, which are pan-specific to pLDH and P. falciparum specific to HRP2. Blood sample was measured in a calibrated dropper capable of delivering 5 μl sample accurately into sample well followed by two drops of assay buffer (60 μl) into developer well. Test card has one control line to indicate the validity of the test procedureHanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 23
  27. 27. In-house style and it’s working condition. Control and test lines appeared within 20 minutes in a reading window. Thus, the RDT is designed for the differential diagnosis between P. falciparum and other Plasmodium species. The interpretation of the test is as described below: Plasmodium falciparum positive reaction The presence of three bands (control, test line 2 and test line 1) or two bands (control and test line 1) indicates a positive result for P. falciparum (or P. falciparum plus other non-falciparum species). Plasmodium vivax or other Plasmodium species positive reaction The presence of two bands (control and test line 2) indicates a positive result for non-falciparum malaria. The pLDH present in the sample reacts with the pan anti-pLDH conjugate and moves through the test strip where the pLDH is captured by pan specific anti-pLDH. Negative reaction The presence of only one band in the control area indicates a negative result. A one-hour workshop, including training in blood collection from finger prick, performance and interpretation of RDT was conducted at National Institute of Malaria Research Field Station Jabalpur (NIMR) under the Indian Council of Medical Research (ICMR) laboratory by one Medical Officer to two Field Laboratory Assistants (FLAs). All specimens were tested on site with the RDT by the FLAs as per manufacturer’s instructions. Simultaneously, thick blood smears were also prepared. Blood smears and microscopy The blood smears were stained with JSB stain [9] and examined on the same day by an experienced microscopist in the laboratory of NIMR, without reference to the results of the RDT/ clinical status. Results of the RDT and microscopy examination were recorded on separate sheets. The microscopist examined 100 microscopic field of thick smear before classifying a smear as negative. Parasite densities were calculated according to the standard method (parasite/μl= no. of asexual parasites × 8,000/no. of WBC counted) [10]. The result of both microscopy and RDT were matched by an independent expert who was blinded to the patient’s clinical status, microscopy and RDT results. Treatment All patients infected with P. falciparum and P. vivax were given standard treatment as per National Vector-Borne Disease Control Programme (NVBDCP). All adult subjects with P. falciparum were administrated the standard oral dose of chloroquine (1,500 mg chloroquine in three days) followed by primaquine (45 mg as a single dose). Non-falciparum cases were given 1,500 mg chloroquine in three days, followed by 15 mg primaquine daily for five days. Infants and children were given proportionally lower doses. Infants were not given primaquine as per National Vector Borne Disease Control Programme.24 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  28. 28. In-house style Quality control If the results of the RDT testing conflicted with that of the microscopy for any sample, the blood smear was re-examined by a different technician. This microscopist was also blinded to the previous microscopy and RDT results. If this re-examination gave a different result to the first examination, the second result was confirmed by a third examination by another technician. Each RDT was saved as documentation for future reference. An independent staff re-read the saved tests after two months and matched with that original interpretation of results. The RDTs were stored properly (temperature 4 – 30°C) and used within shelf life. Only tests from one batch were used (Manufacture June 07, expiry January 09 batch no. 61F0107). Data analysis The performance of RDT was expressed by calculating the sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for P. falciparum and non falciparum malaria separately taking microscopy results as gold standard. The figures for specificity, sensitivity, predictive values and efficiency were calculated as suggested by Tjitra et al [11]. Data were double entered, validated and analysed using Epi Info™ 3.3.2 software (CDC Atlanta GA, USA). Proportions were compared using the chi-square test. The study protocol was approved by the ethics committee of the NIMR, Delhi.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 25
  29. 29. In-house style Contoh - Methods Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study BMJ 2001;323:1389-93 Methods Location The study was conducted in Kengeja village on the island of Pemba north of Zanzibar. The environment is rural, with fishing and farming as the main occupations. P falciparum is holoendemic and transmitted throughout the year, and P malariae is also present. A number of helminths are highly endemic in this population, including two hookworm species, Ascaris lumbricoides, Trichuris trichiura, and Schistoma haematobium. Study sample and randomisation We estimated that 640 children were needed for a 5 g/l difference in mean haemoglobin response in two age subgroups to be seen, with =0.05 and =0.10. During June and July 1996, a census was conducted in Kengeja and a database of all children whose age was reported by their parents as 3-56 months was created. The database contained 684 children from 451 households. Their parents were invited to enter their children in the trial. Households, rather than children, were randomly allocated to receive iron or placebo, so that mothers of siblings would have to manage only one bottle of supplement. Of the 684 children identified in the census and randomised to treatment, 614 attended the baseline clinic at the local primary healthcare centre during September 1996. In total, 538 children completed the follow up period of 12 months, including the final clinical assessment during September 1997. The randomisation and retention of children in the trial is shown in the figure. The developmental scales were not appropriate to be used for the entire age range of the children in the study; language development is reported for children aged 12-48 months at baseline and motor development for children aged 12-36 months at baseline. Interventions Iron treatmentIron treatment consisted of a ginger flavoured liquid supplement containing 20 mg/ ml ferrous sulphate, or an identical placebo (both supplied by Alpharma USPD, Baltimore). At the baseline clinic, each mother was trained on how to give a 0.5 ml dose (equivalent to 10 mg iron) to her children, and she was instructed to give this dose daily for the next year. During the 12 month trial, study staff visited each mother weekly to ask how many days in the past week she had given the supplement to her child and to deal with any compliance problems. Anthelmintic treatment Anthelmintic treatment consisted of 500 mg mebendazole in an orange flavoured chewable tablet, or an identical placebo tablet (Pharmamed, Zejtun). After the26 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  30. 30. In-house style baseline clinic, study staff made home visits to all children every three months to give the anthelmintic treatment. Oral iron Children with severe anaemia (baseline clinic haemoglobin <70 g/l) were treated with oral iron 60 mg/day for 30 days; they were also given their randomly allocated iron. The total iron dosage for these severely anaemic children for the first month of the study, therefore, was 60 mg/ day or 70 mg/day. These children were also given mebendazole (500 mg) in place of their randomly allocated anthelmintic treatment, but they subsequently received their randomly allocated treatment at the baseline clinic. Parents were informed that their child was severely anaemic and the treatments given were explained. These children were included in the subsequent analyses on an intention to treat basis. Assessments Clinical assessmentsThe numbers of helminth eggs in faecal samples were counted for 591 (96%) of 614 study children by the Kato-Katz method.15 Anthropometric measures were converted to z scores with Anthro version 3.0 (CDC, Atlanta). Stunting was defined as height for age z score <2.0, wasting as weight for height z score <2.0, and underweight as weight for age z score <2.0. Blood samples (3 ml) were collected to determine haemoglobin concentration, erythrocyte protoporphyrin concentration, the numbers of malaria parasites, and serum ferritin concentrations. Developmental assessmentsMotor and language development were assessed by the parents reporting gross motor and language milestonesa method known to have considerable accuracy and sensitivity for identifying developmental delays.16-19 Analysis of treatment effects Several characteristics (sex, breast feeding, stunting and developmental scores), were unbalanced between the groups (table 1). To adjust for baseline imbalances we included baseline developmental scores, age (months), sex, haemoglobin (g/l), anthropometric measures (z scores), and presence of 5000 malaria parasites/µl blood as in generalised linear models. 20 21 To look at variables that might modify the effects of treatment on developmental outcomes, we tested the interaction term of treatment (iron or mebendazole) with each variable.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 27
  31. 31. In-house style Contoh - Methods Sudden death and defibrillators in transposition of the great arteries with intra-atrial baffles - A multicenter study Circulation: Arrhythmia and Electrophysiology. 2008;1:250-7. Methods Study Population The study cohort consisted of patients with D-TGA, a Mustard or Senning baffle, and an ICD implanted before January 2006 from the following 7 participating sites: 5 centers within the Canadian Adult Congenital Heart Network (Montreal Heart Institute, Quebec; Toronto General Hospital, Ontario; McMaster University Medical Center, Ontario; St Paul Hospital, British Columbia; Hôpital Laval de Québec, Quebec); Leeds General Infirmary (Leeds, United Kingdom); and Children’s Hospital (Boston, Mass). Patients with congenitally corrected TGA or TGA in the setting of a Rastelli repair were excluded. Baseline Characteristics A similar protocol was previously described in patients with tetralogy of Fallot.9 Data collection was conducted in accordance with individual hospital institutional review board policies. Details regarding demographic variables, surgical history including type of intra-atrial baffle repair (ie, Mustard or Senning), associated anomalies, interventions before or concomitant with surgical repair, electrocardiography, chest radiography, 24-hour Holter monitoring, 2D and M-mode Doppler echocardiography, cardiac magnetic resonance (CMR) imaging, cardiac catheterization, and electrophysiology studies were collected. The most recent data preceding ICD implantation were requested, with a maximum acceptable time interval of 2 years. Electrocardiographic data included heart rate, presence of an underlying ventricular-paced rhythm, longest dominant QRS duration, and QT intervals. Cardiothoracic ratios were derived from posterioanterior chest radiographs. The number of premature ventricular complexes in 24 hours and presence of nonsustained ventricular tachycardia (3 beats, <30 seconds) were captured from Holter monitors. Echocardiographic and CMR data included biventricular size and function, degree of valvar regurgitation, and estimates of systolic pulmonary arterial pressure. When both echocardiographic and CMR studies were performed, CMR data were retained. Data extracted from programmed ventricular stimulation studies included inducibility of sustained monomorphic or polymorphic ventricular tachycardia. ICD Implantation Indications prompting ICD implantation were recorded and included presyncope/dizziness, syncope, palpitations, clinical nonsustained ventricular tachycardia, QRS duration 180 ms, severe systemic ventricular systolic dysfunction, inducible ventricular tachycardia, clinical sustained ventricular tachycardia, ventricular fibrillation/resuscitated cardiac arrest, and other. Patients were stratified according to whether the ICD was indicated for primary or secondary prevention. “Secondary prevention” was defined by clinical sustained ventricular tachycardia, ventricular fibrillation, or resuscitated cardiac arrest. As per convention, barring such events, the ICD was considered indicated for “primary prevention.”28 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  32. 32. In-house style Procedural characteristics were logged and medical therapy at the time of discharge was noted, with particular attention to β-blockers, amiodarone, sotalol, dofetilide, and class IA or IC antiarrhythmic agents. ICD Shocks The main outcome consisted of appropriate ICD shocks. The ventricular tachycardia cycle length, programmed defibrillator zone (ie, slow ventricular tachycardia, fast ventricular tachycardia, or ventricular fibrillation), and success or failure of therapy was noted. Data regarding inappropriate ICD shocks were likewise collected. All ICD events (ie, antitachycardia pacing or shock) and tracings were requested, up to a maximum of 5 per “appropriate” and “inappropriate” category for each patient. A blinded adjudicating committee reviewed and classified all ICD events, with each tracing analyzed by 2 independent electrophysiologists. Appropriate therapy was subclassified as monomorphic ventricular tachycardia (ie, electrogram with a uniform and constant morphology), polymorphic ventricular tachycardia (ie, electrogram with relatively constant amplitude but displaying a shift in morphology or axis), or ventricular fibrillation (ie, constant shift in axis and morphology of the electrogram accompanied by marked and variable changes in amplitude). Inappropriate ICD shocks were further categorized according to type of most likely underlying rhythm (ie, noise interference or oversensing, sinus tachycardia, atrial flutter, atrial fibrillation, and other form of supraventricular tachycardia). ICD Complications ICD complications were considered “periprocedural” if they occurred within 30 days of implantation and “late” thereafter. Late complications were subdivided into lead and generator-related events. Lead-related complications included lead dislodgement, lead failure, endocarditis, and undersensing or oversensing. Pain, erosion, pocket infection, migration, and device malfunction were considered generator-related complications. Statistical Analysis Time zero was defined as time of ICD implantation. Patient-years were accrued from time of entry until occurrence of an ICD shock or the study termination date. Censoring occurred in the event of cardiac transplantation, loss to follow-up, or death from other causes not involving ICD therapy. Continuous variables are summarized by mean±SD or median and interquartile range (25th, 75th percentile), depending on normality of distribution. Categorical variables are represented by frequencies and percentages. Baseline comparisons between patients with ICDs for primary versus secondary prevention were performed by Mann-Whitney rank sum, student t, or 2 tests where appropriate. Freedom from appropriate and inappropriate ICD shocks and overall survival was plotted using the Kaplan-Meier method, with comparisons by log-rank statistics. To assess predictors of ICD shocks, univariate and stepwise multivariate Cox proportional hazard models were used after verifying proportional-hazards assumptions. Variables with probability values <0.1 in univariate analyses were considered in multivariate models. Two-tailed probability values <0.05 were considered statistically significant. Analyses were performed with SAS version 9.1 (SAS Institute, Cary, NC).Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 29
  33. 33. In-house style6. Results • Results sebenarnya merupakan inti laporan penelitian, merupakan hal yang terpenting, namun tidak jarang merupakan bagian yang paling pendek dibanding Methods dan Discussion. • Tuliskan hasil penelitian dengan sekuens yang logis, sesuai dengan alur penelitian. Pada umumnya hasil diawali dengan jumlah dan karateristik subjek penelitian. • Pada studi perbandingan (uji klinis atau kohort) tabel pertama pada Hasil hampir selalu merupakan deskripsi kelompok subyek pada kelompok-kelompok yang diperbandingkan (sering disebut sebagai baseline characteristics). Dahulu tabel perbandingan sebelum intervensi ini selalu disertai dengan uji hipotesis (uji statistika) untuk memperlihatkan bahwa antara kedua kelompok tidak berbeda, yang ditandai dengan P > 0.05. Praktik ini sudah banyak ditinggalkan, dan Paediatrica Indonesiana tidak menganutnya lagi. Jadi deskripsikan saja nilai- nilainya tanpa uji statistika. Apakah kedua kelompok berbeda atau tidak, dilihat dari angka-angka nominalnya (misalnya rerata usia pada Kelompok A adalah 32 (simpang baku 3) tahun sedangkan Kelompok B 34 (SB 4) tahun, apakah 32 vs. 34 tahun tersebut berbeda secara klinis?  Jangan memberikan ulasan atau komentar (dengan membandingkan dengan pustaka) atau pendapat pribadi dalam Hasil. Komentar dan perbandingan ditempatkan pada Diskusi.  Dalam nas (text) jangan diulang-ulang informasi yang sudah dituliskan dalam tabel (misalnya nilai rerata dan simpang baku, nilai P, dan seterusnya), kecuali untuk memberikan penekanan atau highlights.  Dalam nas tuliskan nomor tabel atau gambar yang ada; jangan ada tabel atau gambar yang tidak dituliskan keberadaannya dalam nas.  Tabel harus self explanatory; angka-angka dan satuan harus tergambar dengan jelas pada tabel.30 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  34. 34. In-house style • Alur subyek penelitian dianjurkan untuk dibuat diagram alur (flow chart, lihat contoh di bawah) sehingga mempermudah pemahaman pembaca.Pediatrics 2009;124:e622–e632Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 31
  35. 35. In-house style a. Bagian deskriptif • Pelaporan hasil penelitian harus dimulai dengan penyajian secara deskriptif karakteristik subjek, biasanya dalam bentuk tabel. • Telah disebut di atas bahwa pada uji klinis, ini berisi deskripsi karakteristik pada kelompok-kelompok sebelum perlakuan. Tabel kesetaraan antar kelompok tersebut TIDAK PERLU dilakukan uji hipotesis (dihitung nilai P-nya), oleh karena beda klinis yang besar dapat memberi nilai P yang tidak bermakna bila jumlah subyek sedikit, sebaliknya beda klinis yang kecil dapat memberi nilai P sangat bermakna bila jumlah subyek sangat banyak. Pada contoh di bawah, misalnya, untuk mengatakan apakah kedua kelompok sebanding dalam hal masa gestasi, kita lihat pada kelompok metronidazol adalah 19,5 kg, sedangkan pada kelompok placebo 19.8 kg. Kita pertanyakan andaikata kita mengobati pasien dengan metronidazol, apakah sikap kita terhadap pasien yang masa gestasinya 19.5 berbeda dengan yang masa gestasinya 19.8? Table 1. Baseline characteristics of the patientsCharacteristic Metronidazole group Placebo group N = 966 N = 987Race or ethnic group, n (%) Black 678 (70.2) 679 (68.8) Non-Hispanic White 144 (14.9) 146 (14.8) Hispanic and other 144 (14.9) 162 (16.4)Marital status, n (%) Never married 596 (61.7) 587 (595) Married or living with partner 317 (32.8) 342 (34.7) Divorced, widow, or separated 53 (5.5) 58 (5.9)Age, mean (SD) yr 23 (6) 23 (5)Prepregnancy weight, mean (SD) kg 70.7 (18.9) 80.8 (20.0)Gestational age at randomization, 19.5 (2.5) 19.8 (2.6)mean (SD) wkData diambil dari: Metronidazole to prevent preterm delivery in pregnant women with asymptomaticbacterial vaginosis. N Engl J Med. 342:534-540.32 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  36. 36. In-house style b. Bagian analitik • Sajikan dalam urutan yang logis. Analisis umum yang pertama-tama dipresentasikan, diikuti oleh analisis yang lebih spesifik. • Hasil yang analisis bila perlu disajikan dalam bentuk tabel. c. Metode penulisan angka • Angka yang terdiri atas satu digit dan tidak diikuti oleh unit ditulis dalam huruf. Contoh: In only three out of six patients were antibiotics given. • Satu digit angka yang diikuti oleh unit ditulis dalam angka. Contoh : We gave 8 mg of diazepam for patients > 10 kg BW. • Angka yang terdiri atas dua digit atau lebih ditulis dalam angka. Contoh: In 15 patients cardiac catheterization was performed. • Jangan menuliskan angka pada awal kalimat, tulislah dalam huruf (kecuali pada abstrak): Contoh: Twenty-five percent of all cases belonged to stage 3 …. • Desimal: untuk memisahkan angka-angka yang lebih dari 3 digit; gunakan tanda koma dengan aturan seperti berikut: 1 Jika empat digit angka ditulis dengan angka lainnya yang terdiri atas 4 digit atau kurang, angka ditulis tanpa koma. Contoh: Out if the 5889 subjects, there were 1256 under-five children. 2 Jika empat digit angka ditulis dengan lima digit angka atau lebih, maka angka- angka tersebut dipisahkan setiap 3 digit dari belakang dengan koma. Contoh: There were 4,573 under-five children out of 14,327 subjects. 3 Lima digit angka atau lebih ditulis terpisah oleh koma setiap 3 digit dari belakang. Contoh: Bali’s population is estimated to be 15,300,000 by the year … 1. Angka yang menunjukkan tahun tidak ditulis terpisah. Contoh: 1983, 2006Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 33
  37. 37. In-house style d. Statistik Ketepatan Numerik Ketepatan numerik yang terlalu rinci tidak menambah informasi dan tidak akan menambah nilai makalah, menjadi sulit untuk dibaca. Hasil yang didapatkan seringkali perlu dilakukan pembulatan. Ada beberapa kriteria: 1. Dalam menyajikan nilai mean, SD, dan statistik lain harus diperhatikan ketepatan data aslinya. a. Pada penulisan nilai mean, hanya perlu ditulis satu desimal lebih daripada data aslinya. b. Standard deviation (simpang baku) dan standard error dapat ditulis dengan satu atau dua desimal lebih dari data asli. c. Nilai t, X2, dan r hanya memerlukan dua desimal. 2. Penulisan persentase (%): a. Bila jumlah subyek >100, persentase cukup dengan 1 desimal kecuali jika jumlah subyek sangat besar. Contoh: 25/150 = 16.7%, 1005/21,354 = 4.71% b. Bila jumlah subyek < 100 (40-100) persentase tidak perlu desimal. Contoh: 14/74 = 19% (bukan 18.92%) c. Dengan jumlah subyek kurang dari 40, cukup ditulis angka yang diobservasi. 7/26: tulis 7/26, bukan 26.9% atau 27% Nilai P • Nilai-P ditulis dengan huruf besar (P) dan tidak miring (italic). • Dalam menyajikan hasil uji hipotesis, hendaknya dicantumkan nilai uji statistik (seperti: t, x2) selain nilai- P. • Gunakan tidak lebih dari 2 desimal untuk menulis t, x2, r. • Secara konvensional, nilai-P ditulis sebagai <0.05 atau <0.01. Dengan adanya program komputer, lebih baik mencantumkan nilai-P berdasarkan hitungan, sebagai contoh 0.07 or 0.02. Tetapi jika nilai-P kurang dari 0.00001, tidak diperlukan untuk menuliskan angka sebenarnya, cukup ditulis < 0.0001. • Nilai-P yang telah dipresentasikan pada tabel tidak perlu diulang dalam nas.34 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  38. 38. In-house style Penulisan SD (standard deviation) dan SE (standard error) • SD atau SE dapat ditulis dengan satu desimal lebih dari nilai mean. Contoh: mean = 298, SD = 34.7 atau 35 • Jangan menuliskan mean dan SD atau SE dengan tanda ± (misalnya 20 ± 4.2) karena akan membingungkan, terutama bila berhubungan dengan nilai negatif. Karena nilai mean seringkali berhubungan dengan rentang (interval), SD dan SE, maka penulisan 3200 ± 271 dapat menyebabkan kebingungan apakah 271 merupakan satu sisi dari interval interval, 1 SD, 2 SD, 1 SE, atau 2 SE. Karenanya penulisan di PI adalah: mean (SD) atau mean (SE). Contoh: The mean gestational age was 37.8 (SD 2.1) weeks…. …. while the mean cholesterol level decreased from 218.4 (SD 23.4) mg/dL to 165.7 (SD 17.4) mg/dL. Penulisan interval kepercayaan • Penulisan tanda ‘±’ sebaiknya dihindarkan dalam penulisan interval kepercayaan. Contoh: Jangan tuliskan: “The mean and its 95% confidence intervals were 8±2 mg/dl”, tetapi: “The mean value was 8 (95% CI 6 to10) mg/dL”.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 35
  39. 39. In-house style7. TableUmum• Tujuan pembuatan tabel adalah membuat penyajian / presentasi substansi makalah lebih jelas. Oleh karenanya tabel harus dibuat dengan cermat; jangan menyajikan tabel bila dengan presentasi naratif apa yang hendak disampaikan sudah jelas. Lebih- lebih lagi jangan membuat tabel yang justru membuat pembaca bingung, misalnya jumlah subyek dalam nas dan dalam tabel tidak sama tanpa diberikan penjelasan.• Jangan membuat tabel yang kompleks, atau bersambung ke halaman berikut (kecuali untuk makalah tertentu).• Tabel harus bernomor dan keberadaannya harus dinyatakan dalam nas. Jangan sampai ada tabel yang tidak disebut dalam nas (tabel liar).• Untuk makalah jurnal, pada umumnya setiap 1000 kata dapat diperlukan 1 tabel, sehingga manuskrip sepanjang 12 halaman mungkin memadai bila mengandung 3 atau 4 tabel.Teknis• Judul tabel ditulis dengan huruf kecil (kecuali huruf pertama dan nama diri), dan tidak diakhiri dengan titik.• Hilangkan garis vertikal dan garis horizontal.• Catatan kaki dituliskan langsung di bawah tabel, dengan tanda yang sesuai.• Batasi tabel 3-4 tiap artikel• Perhatikan satuan dan penulisan tanda-tanda statistika36 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  40. 40. In-house styleTable 1. Description of study groups at the time of randomization Parameter Experimental group Control group n = 124 n = 122Male gender, n (%) 51 (41.1) 53 (43.4)Age, mean (SD) yr 37.4 (4.5) 40.2 (4.3)Weight, mean (SD) kg 68.3 (4.4) 67.7 (5.1)Height, mean (SD) cm 165.3 (6.2) 166.8 (6.9)Body Mass Index, mean (SD) 23.2 (6.4) 24.0 (6.1) <24, n (%) 69 (55.6) 67 (54.9) >24, n (%) 55 (44.4) 55 (45.1)Total cholesterol, mean (SD) mg/dL 184 (13) 193 (17)Hemoglobin, mean (SD) g/dL 12.3 (2.4) 11.9 (3.2)Nutritional status, n (%) Undernourished 12 (9.6) 10 (8.2) Well-nourished 68 (54.8) 71 (58.2) Overweight 31(25.0) 26 (21.3) Obese 13 (10.5) 15 (12.3)Perhatikan bahwa semua satuan (unit), persentase, simpang baku dst. tertulis di kolom paling kiri. Kolomselebihnya menunjukkan nilai yang ditemukan. Pada kolom usahakan tidak ada penjelasan lain kecuali namakelompok dan jumlah subyek.Hal yang sama juga diberlakukan untuk tabel dengan hasil uji hipotesis sebagai berikut: Parameter Experimental group Control group P value n = 124 n = 122Cardiovascular death 51 (41.1) 53 (43.4) 0.089Overall death 37.4 (4.5) 40.2 (4.3) 0.042Total cholesterol 68.3 (4.4) 67.7 (5.1) 0.099HDL cholesterol 165.3 (6.2) 166.8 (6.9) 0.231Body Mass Index, mean (SD) 23.2 (6.4) 24.0 (6.1) 0.071Nutritional status, n (%) Undernourished 12 (9.6) 10 (8.2) 0.044 Well-nourished 68 (54.8) 71 (58.2) 0.032 Overweight 31(25.0) 26 (21.3) 0.045 Obese 13 (10.5) 15 (12.3) 0.051Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 37
  41. 41. In-house style7. Figures• Seperti halnya tabel, gambar dibuat agar penyajian lebih jelas. Bila dengan narasi sudah jelas, tidak perlu dibuat gambar. Demikian pula informasi yang sudah cukup dimuat dalam tabel tidak perlu dibuat gambanya.• Gambar harus telah dibuat secara professional, editor tidak akan menggambar ulang.• Pada artikel yang berasal dari tesis, tidak jarang kata-kata dalam gambar tidak diterjemahkan dalam bahasa Inggris. Ini mutlak harus dihindarkan.• Paediatrica Indonesiana tidak memuat gambar berwarna. Jadi gambar atau foto harus dikirim dalam bentuk hitam-putih, sebab gambar atau foto berwarna bila dicetak hitam putih kontrasnya menjadi kurang jelas.38 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan
  42. 42. In-house style8. Discussion• Apa yang harus dibahas dalam Discussion sangat bervariasi, namun pada umumnya:Discussion diawali dengan highlight penemuan utama dalam penelitianKemudian dibahas makna temuan penelitian, dengan cara: o Membandingkan hasil penelitian dengan pengetahuan atau hasil penelitian sebelumnya – apakah menyokong, menolak, atau sebagian menyokong, sebagian bertentangan, sebagian tidak jelas? o Menghubungkan temuan dengan aspek praktik klinis, sosial, serta ilmiah Semua hasil yang relevan harus dibahas. Ini tidak berarti Discussion harus berpanjang lebar. Seperti semua bagian makalah, Discussion juga harus memperhatikan prinsip ringkas, akurat, dan mudah dipahami• Jangan mengulang secara berlebihan informasi yang telah disajikan dalam Results. Gunakan beberapa hasil kunci sebagai kalimat pendahuluan untuk menginterpretasikan hasil• Kelemahan dan kekurangan penelitian disebutkan dan dibahas dampaknya terhadap hasil.• Hindarkan pengulangan kalimat pembuka dalam beberapa pargraf bertururt-turut, seperti: o In this study .... o In this study .... o In this study....• Naskah diakhiri dengan kesimpulan penelitian. Pada umumnya tidak diperlukan anak-judul; paragraf terakhir diskusi merupakan kesimpulan. Kesimpulan harus menjawab pertanyaan yang ditulis dalam Introduction, dan harus berdasarkan pada data penelitian, bukan pada tinjauan pustaka.• Dapat disertakan saran untuk penelitian selanjutnya.Hanya untuk kalangan sendiri, tidak diperjual belikan Paediatr Indones, In-house style 2010 • 39
  43. 43. In-house style Contoh - Discussion Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet N Engl J Med 2008;359:229-41. DISCUSSION In this 2-year dietary-intervention study, we found that the Mediterranean and low-carbohydrate diets are effective alternatives to the low-fat diet for weight loss and appear to be just as safe as the low-fat diet. In addition to producing weight loss in this moderately obese group of participants, the low-carbohydrate and Mediterranean diets had some beneficial metabolic effects, a result suggesting that these dietary strategies might be considered in clinical practice and that diets might be individualized according to personal preferences and metabolic needs. The similar caloric deficit achieved in all diet groups suggests that a low-carbohydrate, non– restricted-calorie diet may be optimal for those who will not follow a restricted-calorie dietary regimen. The increasing improvement in levels of some biomarkers over time up to the 24-month point, despite the achievement of maximum weight loss by 6 months, suggests that a diet with a healthful composition has benefits beyond weight reduction. Pada paragraf berikutnya penulis mengemukakan kelemahan dan kekuatan penelitian: The present study has several limitations. We enrolled few women; however, we observed a significant interaction between the effects of diet group and sex on weight loss (women tended to lose more weight on the Mediterranean diet), and this difference between men and women was also reflected in the changes in leptin levels. This possible sex-specific difference should be explored in further studies. The data from the few participants with diabetes are of interest, but we recognize that measurement of HOMA-IR is not an optimal method to assess insulin resistance among persons with diabetes. We relied on self-reported dietary intake, but we validated the dietary assessment in two different dietary-assessment tools and used electronic questionnaires to minimize the amount of missing data. Finally, one might argue that the unique nature of the workplace in this study, which permitted a closely monitored dietary intervention for a period of 2 years, makes it difficult to generalize the results to other freeliving populations. However, we believe that similar strategies to maintain adherence could be applied elsewhere. The strengths of the study include the onephase design, in which all participants started simultaneously; the relatively long duration of the study; the large study-group size; and the High rate of adherence. The monthly measurements of weight permitted a better Understanding of the weight-loss trajectory than was the case in previous studies. Baru kemudian dibahas setiap aspek dari Results (tidak dikutip).40 • Paediatr Indones, In-house style 2010 Hanya untuk kalangan sendiri, tidak diperjual belikan

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